An Ermer Law Group PLLC service providing Federal Employees Health Benefits Program and general health benefits law and policy information -- but not legal advice

Saturday, May 26, 2007

Miscellany / Weekly Wrapup

On the HIPAA National Provider Identifier (NPI) compliance date, May 23, CMS finally announced the publication of the NPI dissemination policy, which will permit payors to download NPIs off a CMS website beginning June 28. Of course, CMS has permitted health plans to create NPI contingency plans and Medicare itself has implemented such a plan. The official notice of the NPI dissemination policy will be published in the May 30 Federal Register. An advance copy of the Notice is available here.

On May 22, a House Education and Labor subcommittee held a hearing on state health care reform movements and their interrelationship with federal law, particularly ERISA. Rep. Tammy Baldwin (D Wisc.) also testified about her bill (H.R. 506 ) which Sen. Voinovich (R Ohio) endorsed at the FEHBP hearing on May 18. Sen. Voinovich noted that Rep. Baldwin’s bill has been endorsed by both the Brookings Institution and the Heritage Foundation. Sen. Voinovich and Sen. Bingaman (D N.M.) have introduced a companion bill (S. 325) in the Senate. Rep. Baldwin’s bill would create a State Health Coverage Innovation Commission that could forward state health plan reform proposals to Congress for fast track consideration and approval. A Covington & Burling attorney testified about ERISA preemption and against state waivers.

On May 10, the House Ways and Means health subcommittee held a hearing on Medicare's quality initiatives. GAO testified about its own analysis of Medicare participating physician practice patterns which found that the patients of outlier physicians -- MDs who treat a disproportionate share of overly expensive patients -- were spread across the country and evidently were practicing medicine inefficiently. CMS plans directed education efforts but needs legislative authority to reduce payments to inefficient MDs. In a related development, the Blue Cross and Blue Shield Association proposed legislation to create "a new, independent institute - funded by all healthcare payers - to provide consumers and providers with much needed information on which medical treatments work best."